Gliederung

Objective: Reactivation of Cytomegalovirus (CMV) may cause opportunistic infections in immunocompromised subjects. Uraemia is a condition associated with deficiencies of humoral and cellular immunity leading to an increased risk for opportunistic infections or reactivation of latent infections. In contrast to other etiologies conferring immunosuppression, the risk for CMV DNAemia in CMV-seropositive patients on chronic hemodialysis (HD) is largely unknown.

Results: 87 out of 173 hemodialysis patients (mean age 64.2Â±16.3 years) gave informed consent and entered this study. No patient showed symptoms attributable to CMV disease. No CMV DNAemia was found using the qPCR method among these 87 hemodialysis patients.

Discussion: In absence of viremia, CMV-IgM antibody detection may rather reveal a polyclonal B cell stimulation than reactivation. 3/4 IgM-positive patients had very high IgG antibody concentrations compared to 53.1% of IgM-negative patients. Relative lymphocyte count tended to be higher in CMV-seropositive patients (17.4% in IgG-negative, IgM-negative vs. 23.3% in IgG-positive, IgM-negative and 25.0% in IgG-positive, IgM-positive patients), but reached no significance. C-reactive protein was not different between CMV-positive or CMV-negative groups.

Conclusions: There was no evidence for CMV DNAemia and therefore, no systemic reactivation in HD patients. Apart from this, evaluation of local reactivation is necessary to clarify these data with respect to host defense in end-stage renal disease patients. Moreover, adequate renal replacement therapy may lower the risk for CMV reactivation.